Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Jun 2024
Randomized Controlled TrialEffectiveness of Dexmedetomidine as Myocardial Protector in Children With Classic Tetralogy of Fallot Having Corrective Surgery: A Randomized Controlled Trial.
Efficacy of dexmedetomidine (DEX) as a cardioprotective agent in Indonesian children undergoing classic tetralogy of Fallot (TOF) repair with cardiopulmonary bypass (CPB). ⋯ Dexmedetomidine during CPB is an effective cardioprotective agent in TOF children having surgery. Postoperative mortality was comparable across groups.
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J. Cardiothorac. Vasc. Anesth. · Jun 2024
Observational StudyImpact of Pressure Recovery Adjustment on Aortic Valve Area Classification of Disease Severity in Transcatheter Aortic Valve Replacement Patients.
To determine the impact of pressure recovery (PR) adjustment on disease severity grading in patients with severe aortic stenosis. The authors hypothesized that accounting for PR would result in echocardiographic reclassification of aortic stenosis severity in a significant number of patients. ⋯ Adjusting calculated AVA for PR resulted in a reclassification of a significant number of adult patients from severe to moderate aortic stenosis. PR was significantly larger in patients who reclassified from severe to moderate aortic stenosis after adjusting for PR. PR appeared to remain relevant in patients with STJ ≥3.0 cm. Clinicians need to be aware of PR and how to account for its effect when measuring pressure gradients with Doppler.
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J. Cardiothorac. Vasc. Anesth. · Jun 2024
Carbon Footprint of Total Intravenous and Inhalation Anesthesia in the Transcatheter Aortic Valve Replacement Procedure.
To quantify and compare the emissions for deep sedation with total intravenous anesthesia (TIVA) and general anesthesia with inhaled agents during the transcatheter aortic valve replacement procedure. ⋯ The patients who received volatile anesthesia were found to have a higher CO2e per case. This difference remained after a subgroup analysis evaluating those patients only receiving sevoflurane and after accounting for the differences in the duration of anesthesia. Data from this study and others should be collectively considered as the healthcare profession aims to provide the best care possible for their patients while limiting the harm caused to the environment.